1526 Pump Report 12-4-14 System Pumping Report,eWastewater Removal
239 A Greenfield Road
South Deerfield, MA 01373
Phone 413-665-3989 Fax 413-665-7358
****** This report will be sent to the BOARD OF HEALTH within 15 DAYS ******
Permit#WO'7,01 MA License# Date of Pumping / n
Address 1526 WESTHAMPTON ROAD
Property Owner TIM PARSONS Address 2
Home Phone (413) 584-3352 Address 3
Bus Phone City FLORENCE
Cell Phone State MA Zip Code 01360
Total Volume: 15\30
Tank Size: 1500 GAL
Concrete
Good
Tank Location MAP ON FILE
Septic Holding Tank l Leach Tank Cesspool Grease Trap
Date of Previous Pumping, If Known: ry144L-1_
Waste Received at Licensed Facility:
Licensed Facility Phone Number: -- -
Town: Jtin
Misc Comments:
Driver: CAC1 - -
Created 4/23/2018 at 9:49:44 AM Page 1 of 1